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脊柱支具对青少年特发性脊柱侧弯不同感觉条件下姿势控制的影响:一项初步分析。

Effect of a spinal brace on postural control in different sensory conditions in adolescent idiopathic scoliosis: a preliminary analysis.

作者信息

Gur Gozde, Dilek Burcu, Ayhan Cigdem, Simsek Engin, Aras Ozgen, Aksoy Songul, Yakut Yavuz

机构信息

Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.

Gata Special Education and Rehabilitation Center, Ankara, Turkey.

出版信息

Gait Posture. 2015 Jan;41(1):93-9. doi: 10.1016/j.gaitpost.2014.09.001. Epub 2014 Sep 16.

Abstract

BACKGROUND

Despite the positive effects of spinal braces on postural stability, they may constrain movement, resulting in poor balance control in patients with adolescent idiopathic scoliosis (AIS). Therefore, assessment of postural dynamics may aid in designing new less-constraining braces.

OBJECTIVES

The effects of a spinal brace on postural stability and Cobb angle were investigated in this study.

METHODS

Thirteen pediatric patients (10 females, three males) with AIS were recruited to participate in the study. Cobb angle was assessed by X-ray analyses, and postural stability was tested by computerized dynamic posturography in braced and unbraced conditions. A polyethylene underarm corrective spinal brace was fabricated for the subjects.

RESULTS

Thoracic and lumbar curvature decreased to 18.88 ± 11.73° and 17.70 ± 10.58°, respectively, after bracing (p < 0.05). Lower equilibrium scores were observed in the "eyes closed" condition and higher scores in the "eyes closed with a swaying support" condition; higher composite equilibrium scores were also observed for the sensory organization test (p < 0.05) in the braced condition. Lower scores were observed for the "toes-up adaptation test" in the braced condition (p < 0.05). In the braced condition, the reaction time was slower in the right-backward direction and movement velocity was higher in the right-front direction on the limits of stability test (p < 0.05). Furthermore, lower on-axis velocity during forward/backward dynamic balance control was observed in the braced condition (p < 0.05).

CONCLUSIONS

Wearing a spinal brace improved postural stability in terms of increased proprioception, equilibrium performance, and rhythmic movement ability in patients with AIS.

摘要

背景

尽管脊柱支具对姿势稳定性有积极影响,但它们可能会限制运动,导致青少年特发性脊柱侧凸(AIS)患者的平衡控制不佳。因此,姿势动力学评估可能有助于设计新的限制较小的支具。

目的

本研究调查了脊柱支具对姿势稳定性和Cobb角的影响。

方法

招募了13名患有AIS的儿科患者(10名女性,3名男性)参与研究。通过X线分析评估Cobb角,并在佩戴支具和不佩戴支具的情况下通过计算机动态姿势描记法测试姿势稳定性。为受试者制作了一个聚乙烯腋下矫正脊柱支具。

结果

佩戴支具后,胸椎和腰椎曲率分别降至18.88±11.73°和17.70±10.58°(p<0.05)。在“闭眼”状态下观察到较低的平衡分数,在“A型框架摆动支撑闭眼”状态下观察到较高的分数;在佩戴支具的情况下,感觉组织测试的综合平衡分数也更高(p<0.05)。在佩戴支具的情况下,“脚趾上抬适应测试”的分数较低(p<0.05)。在佩戴支具状态下进行稳定性极限测试时,右后方向的反应时间较慢,右前方向的运动速度较高(p<0.05)。此外,在佩戴支具的情况下,前/后动态平衡控制期间的轴上速度较低(p<0.05)。

结论

佩戴脊柱支具在增加本体感觉、平衡能力和有节奏运动能力方面改善了AIS患者的姿势稳定性。

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